Objectives: To evaluate the effect of vaginal lavage with diluted chlorhexidine on mother-to child transmission of HIV (MTCT) in a breastfeeding population.
Methods: This prospective clinical trial was conducted in a governmental hospital in Mombasa, Kenya. On alternating weeks, women were allocated to non-intervention or to intervention consisting of vaginal lavage with 120 ml 0.2% chlorhexidine, later increased to 0.4%, repeated every 3 h from admission to delivery. infants were tested for HIV by DNA polymerase chain reaction within 48 h and at 6 and 14 weeks of life.
Results: Enrolment and follow-up data were available for 297 and 309 HIV-positive women, respectively, in the non-lavage and the lavage groups. There was no evidence of a difference in intrapartum MTCT (17.2 versus 15.9%, OR 0.9, 95% Cl 0.6-1.4) between the groups. Lavage solely before rupture of the membranes tended towards lower MTCT with chlorhexidine 0.2% (OR 0.6, 95% Cl 0.3-1.1), and even more with chlorhexidine 0.4% (OR 0.1, 95% Cl 0.0-0.9).
Conclusion: The need remains for interventions reducing MTCT without HIV testing, often unavailable in countries with a high prevalence of HIV. Vaginal lavage with diluted chlorhexidine during delivery did not show a global effect on MTCT in our study. However, the data suggest that lavage before the membranes are ruptured might be associated with a reduction of MTCT, especially with higher concentrations of chlorhexidine.

@article{137424,
abstract = {Objectives: To evaluate the effect of vaginal lavage with diluted chlorhexidine on mother-to child transmission of HIV (MTCT) in a breastfeeding population.
Methods: This prospective clinical trial was conducted in a governmental hospital in Mombasa, Kenya. On alternating weeks, women were allocated to non-intervention or to intervention consisting of vaginal lavage with 120 ml 0.2\% chlorhexidine, later increased to 0.4\%, repeated every 3 h from admission to delivery. infants were tested for HIV by DNA polymerase chain reaction within 48 h and at 6 and 14 weeks of life.
Results: Enrolment and follow-up data were available for 297 and 309 HIV-positive women, respectively, in the non-lavage and the lavage groups. There was no evidence of a difference in intrapartum MTCT (17.2 versus 15.9\%, OR 0.9, 95\% Cl 0.6-1.4) between the groups. Lavage solely before rupture of the membranes tended towards lower MTCT with chlorhexidine 0.2\% (OR 0.6, 95\% Cl 0.3-1.1), and even more with chlorhexidine 0.4\% (OR 0.1, 95\% Cl 0.0-0.9).
Conclusion: The need remains for interventions reducing MTCT without HIV testing, often unavailable in countries with a high prevalence of HIV. Vaginal lavage with diluted chlorhexidine during delivery did not show a global effect on MTCT in our study. However, the data suggest that lavage before the membranes are ruptured might be associated with a reduction of MTCT, especially with higher concentrations of chlorhexidine.},
author = {GAILLARD, P and MWANYUMBA, F and Verhofstede, Chris and Claeys, Patricia and CHOHAN, V and Goetghebeur, Els and MANDALIYA, K and NDINYA-ACHOLA, J and Temmerman, Marleen},
issn = {0269-9370},
journal = {AIDS},
language = {eng},
number = {3},
pages = {389--396},
title = {Vaginal lavage with chlorhexidine during labour to reduce mother-to-child HIV transmission: clinical trial in Mombasa, Kenya.},
volume = {15},
year = {2001},
}